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TOPLINE:

Hormonal intrauterine devices (IUDs), unlike oral contraceptives, were not linked with an increased risk for melasma in women with menorrhagia, this study found.

METHODOLOGY:

• Researchers analyzed data from the TriNetX Research Network spanning 95 healthcare organizations from 2001 to 2024, identifying patients with menorrhagia aged 18-52 years who received hormonal contraceptives.
• Four cohorts included those using combined oral contraceptives (n = 34,286), progestin-only contraceptives (n = 11,831), or hormonal IUDs (n = 10,223), and control individuals who took no hormones.
• Melasma outcomes were assessed after propensity score matching adjusted for demographics, medications, and comorbidities.

TAKEAWAY:

• Combined oral contraceptives significantly increased melasma risk at 1 year (risk ratio [RR], 2.46; 95% CI, 1.22-4.95), 3 years (RR, 3.25; 95% CI, 2.06-5.14), and 5 years (RR, 3.47; 95% CI, 2.37-5.08).
• Progestin-only contraceptives significantly increased melasma risk at 3 years (RR, 2.30; 95% CI, 1.10-4.84) and 5 years (RR, 2.08; 95% CI, 1.07-4.03) but not at 1 year (RR, 1.00; 95% CI, 0.42-2.41).
• Hormonal IUDs were not associated with the risk for melasma at 1 year (RR, 1.00; 95% CI, 0.42-2.40), 3 years (RR, 0.90; 95% CI, 0.47-1.72), or 5 years (RR, 0.88; 95% CI, 0.50-1.56).

IN PRACTICE:

“The lack of a significant association between hIUDs and melasma incidence suggests that IUDs may be a better option for women concerned about dyspigmentation,” the study authors wrote.

SOURCE:

This study was led by Debby Cheng, BA, Harvard Medical School, Boston, and was published online on April 24 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

Dose-response relationships were not evaluated. Additional limitations included treatment adherence and potential misclassification of conditions.

DISCLOSURES:

This study did not receive any funding. Two authors reported receiving honoraria and advisory fees from multiple companies, including AbbVie, Sun Pharma, Pfizer, Digital Diagnostics, Eli Lilly and Company, and Equillium.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.